Cervical Dilation and Effacement

19 Nov Cervical Dilation and Effacement

ÂCervical dilationÂ and ÂeffacementÂ are terms that you will hear your care provider talk about toward the end of your pregnancy and throughout your labor. These terms refer to the opening and thinning of the cervix. Dilation is measured in centimeters, from 0-10cm, and being at 10 cm means that you are fully dilated and can start push when you feel the urge to do so. Effacement is the thinning and shorting of the cervix measured in percentages, from 0-100%, and being at 100% means your cervix is paper-thin.

It is not uncommon for me to hear students come in and proclaim that they are 1cm dilated and expect labor to start any moment. Realistically, that is probably not going to happen. You can walk around dilated for several weeks before the onset of labor. As a labor support doula, I am more interested in how effaced a client is than how dilated. If the cervix is not shortening and thinning it doesn’t really matter much that it is has opened a bit. The cervix will not open significantly if it is not effaced very much. Once the cervix is on its way to fully becoming effaced, change in dilation will often happen.

What can you do to help effacement? The cervix becomes soft or effaced by the secretion or application of prostaglandins. “Prostaglandins are produced by the mother’s body as well as by the fetus and placenta.” (Holistic Midwifery pg 190) However, there are some other nonpharmaceutical ways to help ripen the cervix. Since semen contains prostaglandins, sexual intercouse is one of the best, natural ways to apply prostaglandins directly to the cervix. I know that toward the end of pregnancy, that may not seem all that appealing, so you can also insert evening primrose oil directly into the vagina. Please note: THIS IS NOT TO BE DONE IF YOUR MEMBRANES HAVE BROKEN! The recommended dosage is 2,500mg capsules a day. This can also be done by taking the oil capsules orally if you are not comfortable with inserting it vaginally.

Another natural method is called “stripping the membranes,” but again, note: THIS PROCEDURE NEEDS TO BE PERFORMED BY A MIDWIFE OR DOCTOR! It is done by the doctor or midwife inserting two fingers inside the cervix and separating the amniotic sac from the cervix. This may stimulate the bodyÂs natural production of prostaglandin. ÂIn two studies, sweeping the membranes successfully induced labor in half the cases attempted.Â (Ina MayÂs Guide to Childbirth. Pg 216.)

If your cervix is not ripening on its own and, for a medically sound reason, your care provider is advising you to be induced, you will receive a vaginal suppository of either cervidil or cytotec. These both contain prostaglandins to help soften the cervix and make it favorable for dilation.

Take a look at the picture below to get an idea of how the cervix shortens and thins out.

Before moving on to discussing dilation, I also want to take a moment to mention the mucus plug. This is just an accumulation of secretions that forms a seal in the cervical canal. Its main function is to create a barrier for infection. As the cervix starts to change, the mother will notice the passing of the mucus plug. Some women describe it as clumpy mucus others experience the release as more of a stringy mucus discharge. The color can be anywhere from pinkish to slightly brownish. The passing of the mucus plug does not guarantee the rapid onset of labor, just an indication that some change is starting to happen.

Cervical dilation can best be described as the baby’s head pushing through a turtleneck sweater. It is the downward pressure applied directly to the cervix that causes the cervix to open. A well-applied head is regarded as being more efficient at dilating the cervix during labor. This pressure is made possible by the uterus contracting around the baby and pushing it downward. Gravity also helps apply pressure to the cervix, which is why squatting can be so beneficial and productive. If you are either stalled in labor or hit a plateau in dilation, it could be a result of poor fetal positioning. Read “Explanation of Fetal Of Position” for more details.

Although this is not to scale, you can get an idea of how the cervix widens and thins until there is no cervix left, at which point full dilation (10 cm) has been reached.

Also keep in mind that second or third time, mothers tend to dilate more, up to 3 or 4 cm before labor even starts. Some mothers may experience this kind of dilation for several weeks before the onset of labor.

The whole reason I was prompted to write this blog was the many questions and concerns that have come up in class. One mother was particularly concerned about doing yoga at 37 weeks pregnant, being 1cm dilated. I always refer to the care provider should there be a medical reason I am unaware of, but for most women, it is fine to continue your yoga practice right up until labor, dilated or not. I wish I could say yoga will help further efface or dilate the mother’s cervix and start labor. The best I can offer is that the yoga practitioner walks (or waddles) out of class more relaxed which is good for the hormonal cocktail that supports labor. But as far as I know, it can not jump start your labor.

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66 Comments

Rinko

Dear Deb, A Happy New Year to you! I read your blog and always admire how you explain not so easy medical terms and subjects well so that we can all understand and have a clear picture/image of it.

Regarding the last paragraph in this blog, as one of the regular students at PYC, I am just curious if you have already thought of doing some kind of survey to see what are the positive effects yoga practices may bring in terms of birth and pregnancy outcome. Of course, it would be very difficult to attribute the effect only to yoga as there are so many confounding factors around the birth/pregnancy outcomes, but something you may be interested in.
Wishing you and the center a productive and successful year 2010.
Rinko

Deb

Thank you so much for your comment. I am very glad that you are enjoying the blogs and your classes at the Prenatal Yoga Center.

I have never conducted a survey among the students as to how yoga attributed to their birth outcome. I am happy to boast that we receive countless emails and letters from mothers that have recently given birth and explained how their yoga practice helped many. Many women talk about how the breath work helped keep them calm and confident. Mantras and self affirmations are also commonly used. For example- “i can do anything for a minute”, “take it one contraction at a time”, “my body was made to do this”, “i can open up and let me baby out” Some mothers also say that feeling part of a community of other strong women gave them courage and confidence.

On a more scientific level, there is a study “Prenatal Yoga May Result in Less Labor Pain, Shorter Labor” which is published on Deb’s blog that explains why prenatal yoga is beneficial during labor. I invite you to take a look at that article.

Thank you again for reading my blog and being part of the Prenatal Yoga Center community.

I hope you have a wonderful 2010 full of happiness, health, laughter and joy!

One of the first signs of labor is the cervical dilation. It can ocurr as early as two weeks before the actual labor process starts, but this initial dilation will not be a threat to pregnancy if it keeps a low dimension (one to two centimeters).

Lynn

Hi. I’m 37weeks and have dialated 3 to 4 centimeters. but my cervix isn’t thin enough and I have lots of contractions but they want to send me home what should I di beg the doctor to go head let me have this healthy baby what should I do?

While I don’t want to tell you how to proceed with your birth since I am not a medical doctor. I will just offer the advice I would give one of my doula clients. First – make sure that you are well hydrated. If you are experiencing contractions but the doctors do not believe you are in labor yet, hydration can help stop or slow down the contractions caused by dehydration.

Secondly- I love the fact that your care providers are sending you home instead of inducing labor. Try to rest and relax and allow your body to naturally go into labor as time goes on. The good news is that you are already 3-4 cm dilated. So something is going on that is moving in the right direction.

If you really want to get things moving and softening in your body, Try acupuncture and evening primrose oil (the latter suggestion ONLY if your water is still intact) and also check w your provider to make sure they are on board with these suggestions.

I bet it is only a matter of days until your little one is snuggled happily in your arms!

Take care
Deb

CINDY

MY DAUGHTER -IN-LAW WAS VERY LAZY DURING HER PREGNACY, FROM THE COUCH TO THE CHAIR AND BACK AND FORTH. SHE DID EAT WELL AND GAINED 65 POUNDS DURING HER PREGNACY. SHE DRANK ALOT OF MILK AND WATER, BUT COME TIME TO DELIVER SHE HAD A VERY HARD TIME. 12 HOURS LATER AFTER BEING 4CM THAT LONG, THE DOCTOR TOLD HER SHE WAS STILL NOT EFFACED ENOUGH AND HAD TO DO A C-SECTION. wHAT WOULD CAUSE HER NOT TO EFFACE?

Thank you for sharing the story of your daughter-in-law. The cervix effaces by the release of the hormone prostoglandin. Before the onset of labor, a woman can help efface the cervix by inserting Evening Primrose oil into the vagina or having sex (semen contains prostoglandin) or the care provider can strip the membranes which stimulates the release of prostoglandin.

Other then that, I can not explain why her cervix did not efface. There may have been some other underlying reasons why after only 12 hours of labor the doctor decided to do a c-section.

Also- the rate of which your daughter in law progressed has very little to do with her exercise habits during pregnancy. Exercise is recommended during pregnancy to help the mother be stronger and more comfortable while dealing with the aches and pains of the changing pregnant body and can also help with stamina and endurance. But it does not predict how long or how quickly labor will be. I have attended a lot of long births from very active women.

The good news is, if your daughter in law decides to have another baby and a VBAC (vaginal birth after cesarean), second births tend to be quicker! 🙂

Hope this answers your question.

Sincerely,
Deb

Chanda

Thank u so much for your clear and concise explanation on effacement and dilation. The best part is the pictures of the different
ratios of effacement. They really helped me put it altogether, now I am
clear as to what’s going on. Thank you.

Evening Primrose Oil helps more with effacement then dilation. I would be doubtful that the EPO will put you into labor. However, it is good that you are being proactive.

Also keep in mind that you are only 38 weeks pregnant. ACOG (American College of Obstetrics and Gynecology) is recommending waiting until 39 weeks for induction. So I would recommend hold off on heavily trying to self induce.

I wish you a happy and healthy birth when the time comes!

Best,
Deb

Jennifer

First off, I love your blog. Can you send me a direct link to it so I can know how to follow you? I’m on my iPhone right now and I’m not 100% sure I will be able to find you after I leave this page lol. My question is.. How soon should one start using the Primrose Oil? I am 32 weeks.. My dr will be inducing at 38weeks due to the babys size. This is my 4th child. I have never tried using the Primrose, but I definitely will be!! 🙂 of course I do not want to go into labor now, just was curious on when do I start taking them? And also are they just as effective when taken orally? Do you prefer a certain brand?
Jennifer

Dee James

I now understand fully what I am going through. I was not sure what to ask, and I was trying to break down the terms the doctor was using during my visit–just got a little confused. This is my second pregancy (two weeks to go), and I was wondering why I was dialating already… I thought maybe I heard something wrong during my doctor’s visit, but now I have a better understanding. Thanks again for this useful information!

Mom

Dear Deb,
I so appreciate your explanation of cervical effacement and dilation. As I am currently pregnany with my first child, it’s important for me to be able to understand what the heck is going on with my body! One thing you mentioned however concerns me,
“If your cervix is not ripening on its own and, for a medically sound reason, your care provider is advising you to be induced, you will receive a vaginal suppository of either cervidil or cytotec. These both contain prostaglandins to help soften the cervix and make it favorable for dilation.”
Cytotec is actually not FDA approved for use in inducing labor. In 2000, the FDA and Cytotec’s manufacturer both issued statements that the only approved use for this drug is the prevention of stomach ulcers. Just wanted to pass along what I have learned! Thanks again for the helpful information!

Tatiany

This post helped me so much! I am a second time around mom to be and I am 37 weeks. I found out I am 4 cm dilated and not effaced. Thanks for the explanation, since with my first pregnancy, it all happened during labor and in less than 24 hours I had my baby boy in my arm! Good luck to all the mom’s to be!!

Melissa

This has been some of the most helpful information I have come across yet, thank you! I am not sure if you are still responding to posts but I figure I will give this a shot. I am 35 weeks with my second pregnancy. My first I was induced at 41 weeks because I was showing not very many signs of labor. I didn’t thin until about 39 and a half weeks and wasn’t dilated at all at 40. When they induced I was in labor for 12 hours and stopped dilating at about 5 or 6 centimeters so they decided to do a c-section. My doctor said it was my body’s way of saying ‘no’ to a vaginal delivery because my baby girl was 9lb 2oz. So now, almost 7 years later I am having my second child. I have been having Bradton Hicks contractions for almost a week now and passed my mucous plug 2 days ago. The baby also dropped significantly over night. Still getting my kick counts, just not as active, but i understand there is less room. Today I was 20% effaced. I never experienced any of this with my first pregnancy. I know in subsequent pregnancies things tend to go faster, would that still be the case for me even though they induced and I didn’t have a successful vaginal delivery last time? If I am starting to efface now should I prepare for labor at anytime from now until my due date?

Congratulations on baby number two! So, let’s take a moment to look at your first birth. Most first time mothers do not go into labor or even show signs of progress before there due date. In fact, on average, a first time mother goes into labor spontaneously at 41 weeks and 1 day. So the fact that after only 12 hours of laboring there was augmentation seems a little premature. Keep in mind- I am just going on what you relayed, I don’t know if there was any other medical indication to why your provider chose to move labor along. It is also not unusual for a labor to move slowly and methodically along- especially with a bigger baby. Your baby and body may need time to negotiate space as to how to move your baby along.

All that said, I have not been able to find studies that show a second labor after a c-section is shorter then a first. But since you did have a chance to labor and your body to respond and dilate- at least to 6 cm., that is promising! If your doctor is open to you going for a vaginal birth after cesarean- VBAC- then, yes- I would be preparing for labor at this point.

I would also encourage you to see if your doctor will allow you to go past your due date before scheduling another c-sections. Concluding a due date is not an exact science, there are variables involved.

I hope you have a wonderful birth and thank you for posting your questions.

All the best,
Deb

Gina

I am 37 weeks 3 days. This is my 3rd pregnancy with both labors being induced (I was stuck at about 3 cm for a couple of weeks with both and at least 50% effacement at the same time-an hour drive to the hospital had doctors concerned I wouldn’t make the drive when I did go on my own, hence induction but at 38 and 39 weeks respectively) I’m trying to avoid induction this time, (labors were 6 hours first time 5 1/2 second time). Last night, for two hours I had quite painful contractions (pitocin flashbacks haha) a couple hours after sex. When I went to get checked this morning, I showed 50% effacement. But baby hasn’t dropped. In your experience how long have you seen effacement continue with no dilation? I’ve not had one without the other… Thank you for your blog 🙂

The relationship between effacement and dilation can vary in terms of advancement. However, you will not dilate too much with out continuing to efface. Meaning, you likely won’t be 8 cm dilated and 50% effaced.

It is also not uncommon for a second or third time mother to have effacement and dilation prior to labor. This is not an indication that labor is eminent. I have had clients walk around for weeks at 2 or 3 cm dilated.

Given this is your third child, your previous labors were not too long and you live a bit from the hospital, you should probably head in pretty soon after feeling the beginning of labor contractions.

In terms of avoiding induction, I understand both concerns, yours and your doctors. Some women I know that have been in a similar situation have found a place to stay closer to their hospital. Given you have two kids at home, I am not sure if this is possible. Just a thought.

But I also suggest making sure you are well hydrated. Try drinking coconut water or Smartwater. These both have magnesium which can slow down contraction. Dehydration could also cause contractions. I also recommend taking it easy. Try to avoid being too active.

The contractions you are feeling may also be Braxton Hicks, painless “practice” contraction.

Hope your little stays in there a bit longer!

Happy birthing – in two weeks! 😉

Deb

Penny

This is a great site that I will be forwarding to my pregnant friends. I was hoping you might have some ideas for me as I’m at my wits end. I’m 37 wks, 2.75 cm dialated, fully effaced, having contractions of various intensity ever 3-5 min for the past 3 days. I have been to l/d 2 times, spent 2-4hrs under observation and then sent home. This is my second child. and I can’t sleep. I think the total for the entire time is 6hrs. My obs response was to prescribe ambient. PLEASE HELP.

I hear your frustration. Good thing is, you are really close to the end of this experience and your body is getting ready for labor.

A few things I suggest, try to do things that are relaxing to you. This will actually help your body ease into labor. I know you already have a little one at home, so maybe get a babysitter so you can have some quiet time before your second one arrives. Take a nice bath, go for a walk, see some friends, take a prenatal yoga class! 🙂

You can also spend a little time with some gentle ways to help ease you into labor. Here are some suggestions- but remember you are only 37 weeks – so still give your body some time.

Festus

Hi,tanks for ua gud advice,my wife z 41 w ,3 days now.for de past one week she had contractions den came to a stop,her due date was 8.7,hoever since 14 she started passing mucus plug resulting to labour which does last for a long tym but no results,its her first pgnant,n am worried,advice mi plz.

jenny

hi there! So I am 39 weeks and 3 days pregnant…. I had my appointment today and was told I am not dialated and given an appointment to come back in, in a week. this is my third child. my first born was 3 days over due, my second was born at 36 weeks. Is it normal that on this pregnancy I am not making any progress? Any advice on what I can do? I am feeling extremely anxious. thank you

I completely understand your anxiety. I would remind you that each pregnancy and baby are different and what happened at one -or two in your case 😉 will not necessarily repeat itself. Some women dilate before the onset of labor and others do not. Also keep in mind you are not even at your due date 🙂

Anna

I have some questions. I’m 22 yrs old and this is my first baby. I am now 5 months pregnant. I bleed on my 9weeks pregnacy,then the doctor advice me to have an ultrasound and we found out that the baby is fine and she gave me duphaston and isoxilan and other vitamins, then on my 10weeks pregnancy, she advice to have an ultrasound again, and my baby is fine but we found out that i have a low lying placenta. Then last july 30, im 18weeks and i had a very abdominal pain, and my doctor told me to have an ultrasound then she said that there’s an opening in my cervix and at the same time we found out that i have an appendicitis so they have to remove my appendix. After the operation, my baby and i are safe. But after a week i felt something on my pubic area, something like there’s a weighing object inside and i felt there’s something coming out. I’m so afraid that my cervix dilate, and lose my baby. I ask my OB about it, but she advice me to take isoxilan. But im curious of what im experiencing now. Please help me. I dont wanna lose my baby. 🙁 what else can i do to prevent miscarriage and low lying placenta and what can i do to make my pregnancy normal. Please help. Thank you so much in advance.

Thank you for reaching out. I hear your concern. Most of this issue lies beyond my realm and I do suggest you follow the advise of your care provider. I can however explain low lying placenta.

Basically the placenta adheres to any place in the uterus. Sometimes the placenta attaches itself low on the uterus and can either fully or partially covering the cervix. Usually as the uterus grows it lifts the placenta up or off the cervix and the issue resolves itself on it’s own. There are some cases where the placenta stay over the cervix. This is called placenta previa.

Again, I recommend you speak with your care provider about this matter since he or she has a clearer picture of your medical condition then I do and they are more qualified to answer these questions.

There is little you can do yourself to stop your cervix from opening. Most of the time to avoid further dilation the mother is put on bedrest. In some case, she is given a cervical cerclage, which is a surgical procedure to stitch the cervix closed.

To my knowledge, I don’t believe bedrest will close your cervix. The hope of bedrest is to stabilize you were you are. Again, I urge you to talk to your care provider about the details of your condition.

Warmly,
Deb

Crystal

Im just wondering how long can i walk around being the 100% effaced that i am with no dialation before i go into labor and since im already effaced is sex a good idea since the semen has nothing to thin ??

Adryenne Johnson

Hi Deb,
I am 40+1 today and I have lost my plug. Currently I am 3 cent. And 60% effaced. Is there anything that I can do to speed this process along? Your blog is awesome.Thanks for all the information!

Adryenne

Kami

Thanks so much for the info, and especially for the graphic depicting effacement! I knew what the term meant, but seeing the picture really helped me visualize what my body is doing now, and what it will need to do in labor. I just think that being able to visualize in my head thinning and opening… will be a really good tool to use in labor to help my body out. Thanks!

Great post. I used to be checking continuously this blog and I am impressed!
Extremely helpful information specially the closing part
🙂 I maintain such information much. I was seeking this certain info for a long time.

Thanks and best of luck.

Jessie

Hi I am 33 weeks. Dilated. 4 thin 70 lost my plug at 31 weeks this is my 5 th baby I hurt all the time how long can I walk around dilated. Dr says I can have baby any day.he gave me shots for baby’s lungs

Thanks for providing this wonderful blog. Your advice makes complete sense in every case that I am reading about and it is of such comfort.

I am currently trying to manage the information being given to me by my Doctor and my Doula. My Doctor, although claiming to be on board with our desire to have a natural (unmedicated) birth using the Hypnobirthing method and the assistance of our Doula is already pushing me towards induction. I am 2 days from my due date and my Doctor is insistent that “nothing good” happens to babies after 41 weeks. Despite what ACOG says, my understanding is it begins to get dangerous after 42 weeks according to them. She has recommended an induction date at 40 weeks and 6 days. I have declined internal exams up to this point so I am uncertain if I am effaced or dilating. When I was checked at 37 weeks internally for Strep B I let them check and I was neither effaced or dilated. I will attempt PRO and regular sex this week to assist with thinning of my cervix. I also have an acupuncture appointment set up for later in the week to assist with dilation in case these processes have not already begun on their own. I wanted to share all of that in case it may be helpful to others in a similar situation seeking natural ways of helping efface, dilate and eventually help go into labor.

My question for you is about the difference in inducing at 41 weeks as opposed to 42 weeks. What are your thoughts about the dangers involved? My Doula says unless there is reason to believe baby is in distress 42 weeks is perfectly safe. I am very much against being induced unless it is medically necessary but how do I know when to safely surrender that for the well being of my baby?

Thank you for writing in and asking your question. To my understanding, full term is not until at least 37 weeks gestation. There has also been a lot of information supporting not inducing labor until 39 weeks unless medically necessary. Although, if you doctor is encouraging you to get things going, sex is helpful as is acupuncture.

I have to say I am in agreement with your doula. Unless medically necessary, induction should be avoided. One of the “dangers” about induction is statistically, it tends to lead to more interventions and c-sections. Maybe you and your doctor can come to an agreement of waiting if you check your amniotic fluid level and have stress tests. Remember my 3 favorite questions when negotiating time.

Is mom ok?
Is baby ok?
Can we have more time?

So if mom and baby are looking good, why not have another day. And this is something that you can take day by day.

How great that you have a bit of a “head start” on dilation without being in labor! I hear your disappoint in remaining at the same dilation from week 37 to 39, but keep in mind, you still haven’t hit your due date yet. Also, second time moms do tend to dilate before labor actually initiates. Since your cervix is already making some progress, chances are once you start contractions, things will move along fairly quickly.

I also love the idea that your provider recommended Evening Primrose oil. That will continue to help your cervix ripen and be ready once labor starts.

I suggest, try to enjoy the last of this pregnancy and rest up for the trip ahead! 🙂

Hi. I am 37 weeks and was on bed rest and medicine for over a month to stop contractions. Now they have taken me off meds and I progressed from 1 1/2 cm and 30% thinned to 3cm and 50% thinned in a week. This is my second child and I live over an hour away from hospital. With my first I was induced at 40week and 1 day and never even had a bh with him. I am wondering if tomorrow at my visit will she put me in hospital or what. Been having a lot of pressure, what I think are false contractions and thin clear/whitish discharge.

I hear your concern about having a quick labor and being far from the hospital. It is not common practice here in NYC to admit someone into the hospital unless they were being induced. I have heard of people getting a hotel room or staying w friends that are closer to the hospital if time and travel are a concern.

kaitlin

hi there, i need some advice. i am currently 36wks 3days pregnant, and i am in latent labour(early labour) and i am currently 1.5cm dilated, and have been for 2 days now. My contractions are lasting about 2 minutes, and they are 1 minute in between. They are getting worse with each contraction. I have been given 2 shots of morphine over the past 2 days to help me sleep(at home) and they told me to go back in if i need more medication. also my water hasnt broken yet. my cervix is at about 30% effaced. and i would like to know how long this “no progress” is going to last, or if there is anything i can do to help speed up the process naturally. Also my son is bigger then usual, measuring as a 39wk old gestation, instead of 36. Any advice or help?

I am sorry that I am not a medical professional and I don’t feel comfortable commenting on your case which seems an exceptional case. Please consult with your care provider. I wish you the best of luck on your delivery and hope you and your baby are happy and healthy.

dena

Hello, im currently 40weeks and 3 days and only 1cm. Im not seeing a doctor currently due to insurance reason therefore i cant scjedule.and induction, however iv gone to the hospital so as to get random check ups but they keep saying im not in labor and wont induce me so they send me home im just really frustrated now cuz its like the baby is making no progress and im scared about being overdue with no doctor plz tel me wat i can do to go into labor i think iv tried everything but nothing seems to work

Shay

I have thoroughly read many of your posts, including Natural Alternatives to Inducing Labor and I had a bit of a worrie-some question.. I am presently 39 weeks pregnant, just saw my OBGYN today and she said I am an “open” 3cm, guessing she means 3cm but going into 4cm and am 50% effaced. My daughter has had her little head facing down for over a month now, and I went into massive contractions and this past thursday. They said I was at that time barely 3cm dilated, and 50% effaced. The doctor at the hospital recommended taking the primrose, but I have no idea where exactly to find that at. My OBGYN also recommended using primrose but in pill form, because I am not keen on sticking things up inside myself and according to my research I’ve lost my mucus plug twice. The first time it was a large clump of clearish ooze, then three weeks afterwards, two days after my first episode of labor, I lost it again but this time it was more of how they describe a “bloody show”.

My OBGYN said she recommends I start taking primrose as soon as I can, considering I’ve had two pregnancies that were exceedingly complicated, one of which never made it to birth and had to be surgically removed and the second of which had to be induced. She is hoping that with me taking two walks a day and taking primrose, it will help me efface and dilate naturally. My primary concern and my question is are there any brand names or places you can think of that I might be able to find this at? If so, that would be greatly appreciated since I’ve tried asking around and no one seems to know what in the world I am talking about. I am wanting to have a normal birth, and so far this pregnancy has been much healthier than the two prior. I just hope I don’t have to have induced labor like I did with my son, especially with my daughter being so healthy up to this point. My doctor is pushing for induced labor if I am not further dilated and effaced by week 41, because she is worried the baby might end up being too large for me to give birth naturally and doing a c-section might end up hurting me in a very bad way. I naturally bleed a lot because my blood is thin, and my veins are exceedingly strong. Her concern is I might end up bleeding out because my blood doesn’t clot well. Any information you can give as to the primrose or anything else that could possibly help with effacement and dilation would be greatly appreciated.

Congratulations on your pregnancy and impending birth. As for the where to get Evening Primrose oil (EPR oil), most natural food stores have carry it. It is believed to help with effacement. But from what you have described, it sounds like things are moving in the right direction. You are not even full term and are at 50% effaced and 3 cm dilated. That is great! Many second time moms experience that kind of progress before the onset of labor, so it sounds like you don’t really need to push things too much! In my option, I would try having sex instead of going for the EPR oil. Semen is a more effective prostaglandin the EPR oil. Prostaglandin helps with effacement.

You can also try acupuncture as a way to help things progress. But again, I don’t think you really need to worry too much. I would bet your body goes into labor naturally on it’s own. And most women experience their second birth as a much quicker, easier experience then the first.

I hope this was helpful. Good luck and happy birthing!!

Deb

Shay

Thank you for your timely response, I greatly appreciate it. My doctor is the one who originally suggested I start taking EPR oil simply because I’ve now been steadily at 3cm dilated and 50% effaced for over a week, and she is worried about the possibility of me being forced into a cesarean. I would go for the option of having sex with my husband, but I’ve already lost my mucus plug and was told that it was a bad idea to have sex after the bloody show. I’m worried that having sex might cause an infection since the plug has already came out. I would try acupuncture, if I knew someone that could do it or a place where I could get it done. My OB said that so long as I can become further effaced, it will help naturally push me to have contractions which will help my body dilate without having induction. I managed to find some EPR oil, and as of tomorrow I will be 40 weeks along. Hoping the EPR oil does its thing before I hit 41 weeks, otherwise my doctor says he will end up pushing for the cesarean. Again, thank you for your time, Deb, I was having one heck of a time trying to figure out where EPR oil was available.

Sincerely

~ Shay

Miranda

I am 37w 5d 4 cm 100% effaced baby head down and bulging bag of water Dr stripped my membrane 3 days ago. And told me to go walk to get my water to break well it never happened. Now all I get is irregular contractions and a lot of discharge. I am so ready but they can’t induce due to the no induction before 39weeks law. Any advice. I am more trying to figure out what all this discharge is its clear and how far dilated u have to be to be admitted or what? O and that is my first pg

It sounds like your cervix is ready to go! Keep in mind that you are just in the window of full term. And as you know, most hospitals and drs prefer to wait until 39 weeks before induction since these last few weeks of gestation are so important to the baby’s lung development. I am a little confused as to why your doctor stripped your membranes so early when your cervix is doing a great job of progressing on it’s own. As for the discharge, it is quite normal to have that during pregnancy. If you are concerned your water broke due to the internal exam, your doctor can do a swab test to let you know.

Best of luck on your journey into motherhood!

Sincerely
Deb

Chanel

Hi, Deb!
I don’t know if you’ll reply to this since your original post is quite old. However, I did have a question. In your original post you said that effacement is more important than dilation. Why do you think that? I am 39 weeks pregnant 80% effaced and almost 2cm dilated this is my first pregnancy. My dr says that my baby is low. Is it normal not to dilated? I have plateaued at 1cm since 35 weeks. What do you think my chances are of going into labor naturally? I am a huge fan of EPO and use is everyday. I also sit on a birthing ball to help my back pain. If I keep going at this rate she wanted to schedule an induction at 40w 3d. I would love some feedback on this situation.

First off, 40w and 3 days is rather conservative to plan and induction if all is medically sound. I would suggest asking your dr -if mom is ok, and baby is ok, can we have more time? this way you are covering your bases of being medically responsible, but still giving your body a chance to start labor on it’s own. Due dates are based on a woman having a 28 day cycle and only going 3 days past the due date does not leave a lot of room of deviation from a perfect 28 day cycle.
Second- it is very normal to plateau with dilation before the onset of labor. Especially if this is your first baby. My own OB and Midwfie never checked me before labor since this information was not particularly useful and is not an indicator as to when labor will start. It just means that your cervix is softening and opening in preparation for labor and to deliver your baby.
Lastly, I view effacement as very important, because before the cervix can open to 10 cm, it needs to shorten and soften. You can not have a long, hard cervix and dilate fully.

Try to stay patient and know that your body is extremely intelligent and knows how to birth this baby. And don’t forget your 3 questions- is mom ok? is baby ok? can we have more time??

I hope you have a wonderful birth and a beautiful journey into motherhood!

Most sincerely
Deb

Chanel

Deb,
Thank you for your reply! It really helped me understand some things better. My amazing little gift of life decided to pick her own birthday. Today I delivered a gorgeous baby girl. I’m so glad I went into my own labor rather than being induced. I’m so in love. Your blog is was so helpful and greatly appreciated!

Chanel

Shelby

Hi deb. I am 32 weeks +3days. I went in 3 days ago do go back pain and bloody discharge followed by a dime sized blood clot. My OB told me I was 2cm dilated and my cervix should be at 4 but instead it is at a 3? Does that mean it is thinning? Also the past two nights around 5pm-9pm I’ve had a consistent back ache with slight hip pressure. I was monitored yesterday and they said I had no contractions, but I had 3 painless contractions 1hr apart from each other, should I be concerned or just wait till my Dr app Tuesday?

Lulu

I am 33wks 3days pregnant and was in the hospital 2 times in one week in pain with tons of pressure and consistent contractions and when I was checked tgey told me that I was 60% effaced and a dimple dilated so they already gave me 2 doeses of steroids for the baby lungs.. is it safe to take take the evening prime rose? Or will that speed up the process to much? Even though they are not giving me any medications to stop the contractions.. thank you hope to hear from you soon!

Thank you for writing in. Please note, I am not a medical professional. My background is in Childbirth Education. I would advise talking to your care provider about your decision whether to take evening primrose oil. In my opinion, it does not seem like it is necessary to take evening primrose oil since you are already effacing earlier then what is ideal.

Good luck and enjoy the journey into motherhood.

Sincerely
Deb

Lucia

I’m pregnant with my 2nd child bow and approaching 6 months. with my first pregnancy my obgyn told me my pelvis was too barrow and I wouldn’t be able to give birth naturally. my labour was induced and I onky dialted 2 cm after the inducing. as a result I ended up having a ceaser.

with all my heart I want to give birth naturally the 2nd time around, do you think its possible for me to try giving natural birth after a ceaser the 1st with a narrow pelvis diagnosis?

many thanks in advance

Taylor

Im 38 weeks im high risk pregnancy this is my 3rd child my first was natural and my second was c-section im trying natural labor with this one I have alot of lower pains but im dialating and my cervix isnt thinning so when I go to the gospital they just send me home what can I do to help thin my cervix and sex is starting to be very painful